Risk of post-procedural bleeding in children on intravenous fish oil

Prathima Nandivada, Lorenzo Anez-Bustillos, Alison A O'Loughlin, Paul D Mitchell, Meredith A Baker, Duy T Dao, Gillian L Fell, Alexis K Potemkin, Kathleen M Gura, Ellis J Neufeld, Mark Puder, Prathima Nandivada, Lorenzo Anez-Bustillos, Alison A O'Loughlin, Paul D Mitchell, Meredith A Baker, Duy T Dao, Gillian L Fell, Alexis K Potemkin, Kathleen M Gura, Ellis J Neufeld, Mark Puder

Abstract

Background: Intestinal failure-associated liver disease (IFALD) can be treated with parenteral fish oil (FO) monotherapy, but practitioners have raised concerns about a potential bleeding risk. This study aims to describe the incidence of clinically significant post-procedural bleeding (CSPPB) in children receiving FO monotherapy.

Methods: A retrospective chart review was performed on patients at our institution treated with intravenous FO for IFALD. CSPPB was defined as bleeding leading to re-operation, transfer to the intensive care unit, re-admission, or death, up to one month after any invasive procedure.

Results: From 244 patients reviewed, 183 underwent ≥1 invasive procedure(s) (n = 732). Five (0.68%, 95% CI 0.22-1.59%) procedures resulted in CSPPB. FO therapy was never interrupted. No deaths due to bleeding occurred.

Conclusions: Findings suggest that FO therapy is safe, with a CSPPB risk no greater than that reported in the general population. O3FA should not be held in preparation for procedures or in the event of bleeding.

Keywords: Fish oil; Intestinal failure-associated liver disease; Omega-3 fatty acids; Post-procedure bleeding.

Copyright © 2016 Elsevier Inc. All rights reserved.

Source: PubMed

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